White Gallbladder-Related Diarrhea and Green Bile Salts Diarrhea

White Diarrhea Due to Gallstones

Normally, bile, produced in the liver, is temporarily stored in the gallbladder and from there, after a fatty meal, expelled into the duodenum.

Gallbladder stones may press on the main bile duct and obstruct it from the outside, thus preventing the bile flow into the duodenum. A small gallstone may move from the gallbladder into the main bile duct, thus obstructing it from the inside. Symptoms of bile duct obstruction include one or more of the following:

  • Right upper abdominal pain (cramps) within an hour after a meal; pain may radiate into the right shoulder and upper back
  • Nausea, vomiting
  • Jaundice
  • White (pale, clay) colored bowel movements due to lack of bilirubin, which gives the stool its normal brown color
  • Loose, foul smelling, sticky, floating, foul smelling stool, which contains unabsorbed fats (this is called steatorrhea: from Greek steato = fat; rhein = flow)

Diagnosis of Gallstones

Big gallstones (> 2 mm) in the gallbladder can be detected by ultrasound but small gallstones can be detected only by  CT. Gallstones in the bile ducts can be detected by CT or ERCP (endoscopic retrograde cholangio pancreatography), where a contrast is injected into bile ducts during upper endoscopy and then an X-ray image is made. More about gallbladder tests.

Treatment of Gallstones

Gallstones in the gallbladder are treated with surgical removal of the gallbladder or, rarely, by dissolving by orally taken bile acids. Gallstones in bile ducts may be removed during ERCP.

Green Diarrhea After Gallbladder Removal

After gallbladder removal, the bile is constantly flowing from the liver into the duodenum. Most of the bile salts from the bile are absorbed from the end part of the small intestine into the blood but this is not always the case. Bile salts that were not absorbed in the small intestine will reach the colon and speed up its peristalsis. This means that water from the stool will not have time to be absorbed and colonic bacteria will not have time to change bilirubin from green to normal brown, resulting in green diarrhea.

Treatment of Green Diarrhea After Gallbladder Removal

Cholestyramine, taken orally, binds excessive bile salts in the bowel and allow them to be excreted with the stool without causing diarrhea (1). Cholestyramine may have several side effects, so this may not be a solution for everyone.

Low-fat diet may help to some affected persons (1).

Fibers from fiber-rich foods may bind some bile salts and thus prevent bile salt diarrhea (1).

Related Articles:

References:

  1. Bile salt diarrhea  (gihealth.com)
About Jan Modric (249 Articles)
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